My thanks to our witnesses for their presentations and for making themselves available to answer our questions.

My first question goes to Ms. Pellerin. In the engagement section of your presentation, you mentioned the possibility of ending the case management relationship when the goals are achieved, and of re-engaging the veteran in the case management process.

Case management services are available to veterans whenever they need them and for as long as they need them.

As I described in my opening remarks, the relationship between the case manager and the veteran is about establishing goals, realistic goals, in terms of what the veteran is likely to achieve from a health, a social, and an employment perspective. Once the veteran has achieved those goals, the likelihood is that the intervention of the case manager is no longer required. The goals have been achieved, and the veteran can reintegrate successfully into civilian life.

If at some future point something happens to the veteran or there is a change in the veteran's situation, either from a health perspective or from an employment perspective, there is an opportunity for the veteran to reconnect with Veterans Affairs. If at that point there is a need for case management intervention and re-engagement with that case management process, that opportunity is provided.

The veteran is disengaged, which is the term we use, when he or she has achieved the goals and is ready to be fully independent in society. But as I said, the opportunity to return to the department at some future point, based on a change in circumstance, is there. It's encouraged. We certainly inform our veterans and our veterans' families of that opportunity.

As I understand it, a veteran has access to a case manager for as long as he has not achieved the goals. The case manager does not decide whether the veteran has achieved the goals and that the relationship is over. It is done by common consent.

The goals are established mutually between the veteran and the case manager. It's not the case manager dictating the goals. It's working with the veteran to establish realistic goals, given the veteran's health situation and given the skills the person has attained through the military and the likelihood of transferring those skills to a civilian employment situation. Providing retraining may be necessary. The goals are mutually established, and when they have been achieved, it's obviously a mutual agreement on that goal attainment.

Mr. Bernier, I have read in some reports that there is a significant lack of clinical psychologists in the Canadian Forces. Is there a plan to hire more, so that we can reduce the psychological distress that veterans are suffering, especially those coming back from Afghanistan, for whom that distress is catastrophic?

Colonel Bernier, in your text you talk about seeking accreditation for your case management program. Could you maybe expand on that a little bit? I imagine that the value of the accreditation is to measure the success of the program. Maybe you could talk a little bit about that.

Accreditation Canada is the national quality assurance body for health systems and health facilities, primarily hospitals, but various other types of health facilities as well. They're completely independent. They have independent peer assessors from across the country who are experts in assessing the quality of health care provided by various systems. They do that not only within Canada but various other countries in the world ask them to accredit theirs as well, because their reputation is so good.

They have accredited our entire Canadian Forces health system and determined very favourably that it ranks among the best. What we didn't do is have a precise, more detailed specific accreditation of the case management system within the armed forces specifically. Independent assessors who are experts in case management will be coming in to assess the quality and report back to us where improvements might be made that we may not have identified on our own.

That's correct. When they do assessments of hospitals or health systems, even ours, even though they tell us verbally that it's one of the best they've ever seen anywhere in the world, their duty is to find things that can be improved. There's no health system anywhere that has a perfect record, although we scored pretty high. Our whole health system, as it stands now, has been improved significantly over the years, because there have been problems in the past, but it will give us a road map for things to improve to make it progressively better.